Guanyuanshu (BL26): The Lowest Back Point Above the Tailbone, for a Deep Ache Low Down

Where Guanyuanshu Sits

This point sits low on the back, about two finger-widths out from the centre of the spine, at the level of the last bump of the lower back. Just below it, the spine gives way to the flat, triangular bone at its base, the one wedged between the two hip bones.

It belongs to the line that Vietnamese and Chinese texts call the Bladder channel. That line begins at the inner corner of the eye, runs over the top of the head, and comes down the back in two tracks on each side of the spine. The inner track, about two finger-widths from the centre, carries a row of transport points. This one, the twenty-sixth stop on the line, is linked to a point on the front of the lower belly, below the navel.

The modern standard from the World Health Organization places it level with the lower border of the fifth lumbar spinous process, one and a half units out from the midline. The spinous processes are the bumps you can feel down the middle of your back, and the fifth lumbar is the lowest one before the flat bone begins. The Vietnamese count, following the old way of numbering from the top of the back, calls this the seventeenth vertebra. One and a half units is about the width of your index and middle fingers laid side by side.

Under the skin is the tough sheet of connective tissue that wraps the lower back like a corset. Beneath it runs the thick lower end of the long muscle that keeps the spine upright (the erector spinae), which here grows into a firm, rounded mass. Deeper, beside the last joint of the spine, lies a group of small muscles that steady each vertebra (the multifidus). The skin is served by small back branches of the lowest lumbar and first sacral nerves.

Why This Spot

On the anatomical side, this is where the whole weight of the upper body passes from the spine into the pelvis. The last joint of the lower back carries more load than any other and bends the most. With the years, the disc here loses height, the small joints at the back of the spine thicken, and the muscles around them tighten to guard them. The result, for many people in their sixties and seventies, is a deep ache low in the back, worse after sitting or standing still and stiff on getting up. This point sits in the middle of it.

In this tradition, the points beside the spine carry energy to the organs and to key places in the body. This one is linked to a point on the front of the lower belly, below the navel, called the Origin Pass. That point is described as the gate where the body's deepest energy is stored. Its partner on the back is said to share in that role. That is why this tradition links it to the base of the spine, the bowels and the bladder. A low back that feels cold and weak, loose bowels, and getting up at night to pass water are read together as signs that this base has grown tired.

The name says as much. Guan is a pass or gate; yuan is the origin; shu means to transport. Its Vietnamese name, Quan Nguyên Du, carries the same meaning.

What the Old Texts Say About Guanyuanshu

Unlike most of its neighbours, this point does not appear in the third-century Systematic Classic of Acupuncture and Moxibustion, the Jiayi Jing. Its first record is usually traced to the Taiping Holy Prescriptions for Universal Relief, the Taiping Shenghui Fang, a large collection compiled at the Song court in the tenth century. It is placed below the seventeenth vertebra, one and a half units out from the spine. It filled the gap in the row of back points between the large intestine point above and the small intestine point below.

The Vietnamese handbook of points and channels by Ngô Trung Triều, published by Hồng Đức, follows the same count. Draw a line across the tip of the fifth lumbar bump, it says, and meet it with a vertical line one and a half units out from the centre. It lists the point for low back pain, loose bowels, and complaints of the urinary and reproductive organs.

Notice how the list fits the place. The base of the spine, the bowels and the bladder all sit at the same level, low in the body. The old teachers chose points by the level they sat at as much as by the exact spot that hurt. In the wider tradition, this point is often pressed and warmed together with the points a little above it and the hollows in the flat bone below it, so the whole base of the back is covered. That reputation rests on long use rather than proof.

Points That Work With Guanyuanshu

The first partner sits one bump higher, level with the line across the tops of the hip bones, the same two finger-widths out from the spine. In this tradition it is the back point for the large intestine. The two are worked one after the other for a deep ache low in the back and for loose or sluggish bowels. A tennis ball moved a little upward reaches it at once.

The second sits higher again, at about waist level, two finger-widths out from the spine. It is the back point for the kidney in this tradition. Pair it with this one when the whole lower back feels weak and cold, and when getting up at night to pass water comes with a tired back.

The third sits in the middle of the crease at the back of the knee. It is one of the most used points for back pain in this tradition, and is easy to reach sitting in a chair. Pair it with this one when the low back is stiff and the legs feel heavy.

How to Find and Press Guanyuanshu

Getting Into Position

Be honest with yourself about reach. Some people can press this point with their thumbs, hands on hips, fingers wrapped forward. But the thumbs tire quickly, and stiff shoulders make it hard. That is normal. Stand with your back to a wall, feet about a foot out from it, knees soft, and use a tennis ball between your back and the wall. A stick with a rounded end, reached around the waist, is another way.

How to Find It

Put your hands on your hips with your thumbs pointing back, resting on the top edge of the hip bones. The line between your thumbs crosses the spine at the fourth bump of the lower back. Go one bump down. That is the fifth and last; below it, the bumps stop and you feel the flatter bone at the base of the spine. Many people have two small dimples a little lower and further out; the point sits just above and inside them. The point lies on each side of the gap below the last bump, two finger-widths out.

Place the ball there and lean back into it slowly. Shift in small steps, a little up, down, in and out. Much of the area will feel like ordinary pressure on thick muscle. One spot will sting: a small, sharp, pinpoint tenderness deep under the ball. That spot is the point. Hunt for the spot that stings, because that is the one. Two balls tied in a sock let you work both sides at once, with the spine resting in the gap between them.

How to Press It

Once you are on the stinging spot, stay on it. Bend and straighten your knees a little, so the ball rubs in small circles about the size of a coin, roughly one each second, without rolling away. With a stick, hold the handle steady, place the rounded tip on the spot and make the same small circles. With your thumb tips, press in and slightly toward the spine. Do not press on the bony bumps themselves.

How Much Pressure

A sharp sting under the ball is right. Stay on it. When you step away, it should fade within moments. If the pain stays after you lift off, spreads, or the area turns swollen, hot or red, stop and leave it for several days. Stop at once for any pain shooting down a leg or any numbness. If you are holding your breath, you are pressing too hard to keep going. Step your feet a little closer to the wall, so less of your weight goes into the ball, until you can breathe slowly through the sting while staying on the spot.

How Long

One to three minutes on each side. Keep the first sessions to about a minute, because the base of the back is often more tender than expected and can feel bruised the next day. Add a little time over the following days, up to three minutes. Work both sides, even when only one complains. Once or twice a day is plenty. Longer sessions bring more soreness, not more benefit.

When to Do It

Morning suits a low back that is stiff on getting up. After a long sit, a few minutes on the ball helps you straighten. Before bed is a good time too, especially if you get up at night to pass water. Do not press in the middle of the night. If you wake in the small hours, go back to bed rather than leaning on a wall, which will only wake you further. Keep the pressing for the day and the evening.

What This Won't Do

It will not undo wear in the lowest joint of the spine, and it will not change a weak bladder or an enlarged prostate. Pressing can ease tight, tender muscle and give you a few minutes of relief, which is real and worth having. What changes a low back over months is plainer: walking most days, gentle strengthening for the hips and trunk, breaks from sitting, a chair that supports the base of the back, and keeping a healthy weight. For night waking to pass water, less to drink in the two hours before bed helps many people. This point works best as one small part of that.

It is no substitute for a diagnosis. Go to hospital at once for numbness between the legs or around the back passage, new trouble controlling your bladder or bowels, or a leg that turns weak. See a doctor promptly for back pain after a fall, especially with thin bones, for pain that worsens week on week, for pain that is worse lying still at night, for pain with fever or weight loss you cannot explain, and for blood in the urine or stool. Getting up to pass water more than once or twice a night, or a weak stream, is worth mentioning to your doctor.

Safety First

If you are pregnant, skip this one. The low back near the base of the spine carries a traditional caution in pregnancy. Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the area alone after a recent back injury or fall, with a known fracture in the spine, after recent back surgery, or with unexplained swelling or a lump. If you take blood thinners, bruise easily, have thin bones or reduced feeling in your legs, use a softer ball, lean in less, keep sessions short, and ask your doctor first.

Stop at once if pain stays after you lift off, spreads, or brings tingling or numbness. Nothing here requires you to push through pain that lingers. For the full list of cautions and the situations where pressing on yourself is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Guanyuanshu (BL26) pressure point? Guanyuanshu (BL26) lies low on the back, about two finger-widths out from the centre of the spine, level with the fifth and last bump of the lower back. Find the bump in line with the tops of your hip bones and go one bump down. In Vietnamese it is called Quan Nguyên Du.

How do I press a point this low on my back? Some people can reach it with their thumbs, hands on hips, but the thumbs tire quickly. Stand with your back to a wall and lean on a tennis ball placed over the spot. Two tennis balls tied in a sock sit on both sides of the spine at once. A stick with a rounded end, reached around the waist, also works.

Can Guanyuanshu (BL26) help a deep ache just above my tailbone? In this tradition Guanyuanshu (BL26) is commonly used for a deep, dull ache low in the back, where the spine meets the flat bone at its base. Many people find the ache softens after pressing. Pain that runs down a leg, numbness, or new trouble with your bladder or bowels needs a doctor.

Can it help with getting up at night to pass water? In this tradition the low back points near the base of the spine are linked to the bladder and the bowels, and this one is listed for both. It will not change a weak bladder or an enlarged prostate. Getting up to pass water more than once or twice a night is worth mentioning to your doctor.

How long should I press Guanyuanshu? One to three minutes on each side. Keep the first sessions to about a minute, then add a little as the days go on, up to three. Once or twice a day is enough. Work both sides, even if only one side aches.

Can I press Guanyuanshu while pregnant? No. If you are pregnant, skip this one. The low back near the base of the spine carries a traditional caution in pregnancy. Ask your midwife or doctor about safe ways to ease back pain.

Other Points in This Library

Each of these sits within reach of the same hand. They are often worked in the same sitting.

This page shares general information about a traditional practice. It is not medical advice and does not replace what your doctor has given you. If you are pregnant, managing a health condition, or unsure whether this applies to you, check with your doctor first.

The whole inner edge of the foot, laid out on one page with photographs, is in The Foot Map — the free book. For every point in this library, see the full pressure point index.

(Point shown: BL26 · Guanyuanshu · Origin Pass Transport Point · Quan Nguyên Du.)